Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THORACIC DISEASES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1988

Hodgkin disease: clinical utility of CT in initial staging and treatment.

One hundred seven consecutive new cases of Hodgkin disease were evaluated with chest radiography and computed tomography (CT) for initial staging. The data were evaluated with regard to five popular treatment protocols for Hodgkin disease. Thoracic CT scans were normal in 30 of 31 patients who had normal radiographs. In the remaining 76 patients, CT demonstrated 194 new sites of disease and disproved 25 suspected sites of disease. The use of CT scans changed the staging of disease in 20 patients, 16 of whom had extranodal extension. The effect of using CT findings on treatment depended on whether radiation therapy was used, and, if so, which treatment protocol was followed. The use of CT findings would have changed the treatment in 6.5%-62.7% of new cases of Hodgkin disease. The authors recommend that CT scans be obtained in all patients with Hodgkin disease, especially those with abnormal chest radiographs.

Adult↗
PubMed1986

Large cell lymphoma of the mediastinum: a B-cell tumour of probable thymic origin.

Fifteen cases of non-Hodgkin's lymphoma of the anterior mediastinum are reported. In the first group of four, fresh tissue was available and immunohistochemical studies demonstrated their B-cell origin, with monotypic immunoglobulin production in two. Only fixed tissue was available in the second group of 11 patients. All stained with antibody to leucocyte common antigen (PD7/26) and three showed monotypic immunoglobulin production. If the two groups are combined seven of the 15 tumours were clearly of B-cell origin. Classification on morphological grounds was difficult, with most tumours showing mixtures of centroblasts and large centrocytes, and the original diagnoses had included Hodgkin's disease (three), thymoma (one) and undifferentiated carcinoma (two). None of the patients had evidence of extra-thoracic disease at presentation and when this developed the organs involved were liver (one), kidney (two) and thyroid (one). Direct extension within the chest led to infiltration of chest wall, sternum, lung, superior vena cava and other structures. The site of origin, lack of nodal involvement and, in one case, presence of residual thymus around the tumour indicate an origin in thymic B-cells.

Adolescent↗
PubMed1996

Painful adult thoracic Scheuermann's disease. Diagnosis by discography and treatment by combined arthrodesis.

This is the case report of a 42-year-old woman with chronic thoracic pain, nonradicular and refractory to all nonoperative treatment. Radiographs showed the classic findings of Scheuermann's disease, but without abnormal kyphosis. Magnetic resonance imaging scans showed multilevel thoracic disc degeneration typical of long-term Scheuermann's disease. Thoracic discography revealed concordant pain at T6-7 and T7-8. Treatment consisted of an anterior fusion, T5-11, and posterior fusion of T3 through L1, with Cotrel-Dubousset instrumentation. At follow-up, she was pain free and able to work full time and had been able to return to golf, her favorite recreation. Discography of the thoracic spine, as of the lumbar spine, can reveal the true source of pain and thus lead to precise and effective treatment.

Adult↗
PubMed2004

[Noninvasive mechanical ventilation in patients with stable severe COPD].

Noninvasive positive pressure ventilation in patients with stable chronic obstructive pulmonary disease. The role of non-invasive positive pressure ventilation (NIPPV) is well documented in patients with restrictive thoracic diseases like kyphoscoliosis, tuberculosis sequelae or neuromuscular disease. There is also a good evidence for the use of NIPPV in acute respiratory failure in patients with an exacerbation of COPD. The application of NIPPV in patients with chronic respiratory failure is growing, but there is less evidence than in restrictive disorders. NIPPV can unload the respiratory muscles in patients with chronic hypercapnic COPD and so alleviates fatigue of the respiratory pump, but improvement in the maximal inspiratory pressure (Pi (max)) is small or even absent. An improvement of sleep quality has also postulated, there was an increase in total sleep time and sleep effectiveness when using higher inspiratory pressure. An increase of the walking distance was shown in short term studies, only. In most studies, there was an increase in quality of life as a main topic. Mortality was unchanged in the two long-term randomised controlled studies. Current data suggest a possible role of NIPPV in patients with severe hypercapnia. A high effective inspiratory pressure and a ventilator mode with a significant reduction in the work of breathing should be choosen. NIPPV should be started in hospital, a close reassessment must be performed. Patients who accepted NIPPV in the first weeks had a good compliance for long-term use.

Humans↗
PubMed1996

Natural history of severe atheromatous disease of the thoracic aorta: a transesophageal echocardiographic study.

OBJECTIVES: This study sought to prospectively observe the morphologic and clinical natural history of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography. BACKGROUND: Atherosclerosis of the thoracic aorta has been shown to be highly associated with risk for embolic events in transesophageal studies, but the natural history of the disease under clinical conditions has not been reported. METHODS: During a 20-month period, 191 of 264 patients undergoing transesophageal echocardiography had adequate visualization of the aorta to allow atherosclerotic severity to be graded as follows: grade I = normal (44 patients); grade II = intimal thickening (52 patients); grade III = atheroma < 5 mm (62 patients); grade IV = atheroma > or = 5 mm (19 patients); grade V = mobile lesion (14 patients). All available patients with grades IV (8 patients) and V (10 patients) disease as well as a subgroup of 12 patients with grade III disease had follow-up transesophageal echocardiographic studies (mean [+/- SD] 11.7 +/- 0.9 months, range 6 to 22). RESULTS: Of 30 patients undergoing follow-up transesophageal echocardiographic studies, 20 (66%) had no change in atherosclerotic severity grade. Of the remaining 10 patients, atherosclerotic severity progressed one grade in 7 and decreased in 3 with resolved mobile lesions. Of 18 patients with grade IV or V disease of the aorta who underwent a follow-up study, 11 (61%) demonstrated formation of new mobile lesions. Of 10 patients with grade V disease on initial study who underwent follow-up study, 7 (70%) demonstrated resolution of a specific previously documented mobile lesion. However, seven patients (70%) with grade V disease also demonstrated development of a new mobile lesion. Of 33 patients with grade IV or V disease, 8 (24%) died during the study period, and 1 (3%) had a clinical embolic event. CONCLUSIONS: The presence of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography is associated with a high mortality rate. Although the morphologic natural history of the disease process itself is marked by stability over a 1-year period, individual lesion morphology is dynamic, with formation and resolution of mobile components occurring frequently over the same period. The dynamic nature of individual lesion morphology potentially enhances the possibility of developing a successful therapeutic strategy.

Aged↗
PubMed1994

[Radiological exploration of the thorax. Strategy and indications].

The widespread use of computed tomography and the advent of magnetic resonance imagery have considerably modified the methods and strategies of thoracic exploration over the last 10 years. Standard radiography remains the first-line examination for all thoracic diseases, and often is the only imagery required; further explorations are indicated on the basis of the information seen on standard films. Computed tomography has become an essential element in the work-up of all diseases involving a tumoural process in the lung. It is also indicated in bronchiestasis and for the exploration of chronic lung diseases. Further information may be obtained with magnetic resonance imagery. Although this method cannot be used to explore the pulmonary parenchyma, it is particularly adapted in cases involving the pleura, mediastinum (tumours and vessels) and the thoracic wall. Scintigraphy is mainly used to detect pulmonary migrations and to investigate lung function before thoracic surgery. Pulmonary angiography remains the reference imagery for the diagnosis of pulmonary embolism but has lost its other indications. Tomobronchography is exceptionally required. Current strategy in infectious diseases is to always begin with standard radiography, then to complete the work-up with further examinations only when necessary. Correct evaluation of tumoural processes relies heavily on tomography even for very small masses since it provides essential information on localization and extension. Management of primary bronchogenic cancers also requires repeated tomographic studies. Magnetic resonance images are indicated on the basis of the tomography results and are particularly useful in tumours of the apex and extension to the spinal column or mediastinum. For chronic bronchopathy, pulmonary scintigraphy is performed after standard films in the preoperative work-up then is sometimes completed with other techniques. In cases of suspected pulmonary emboli, a normal scintigraphy can eliminate the diagnosis. Inversely, certain teams propose coupling perfusion scintigraphy with ventilation scintigraphy to detect mismatches, particularly distinctive signs of pulmonary emboli. When the diagnosis remains uncertain, pulmonary angiography is the reference imagery technique.

Angiography↗
PubMed1988

Hodgkin disease: CT of the thymus.

The computed tomography (CT) scans in two groups of patients with Hodgkin disease were reviewed to determine the frequency of thymic enlargement. In 50 CT scans from 50 patients with evidence of thoracic disease on CT scans who were examined for primary staging, the thymus was enlarged in 15 of 50 (30%). Fifty CT scans were obtained from 44 patients at the time of 50 separate episodes of known or suspected relapse. Relapse occurred in the mediastinum in 12 episodes, lung parenchyma in five, and both sites in one. Thymic enlargement thought to be due to involvement by disease was present in seven of 18 (38%). Mediastinal disease was associated with thymic enlargement in all but one patient in whom a thymic cyst developed after radiation therapy. Differentiation of thymic enlargement from enlarged superior mediastinal lymph nodes was easily made in all but two patients. Thymic enlargement in the absence of lymph node enlargement may indicate a different disease, since isolated Hodgkin disease of the thymus is uncommon. Primary thymic tumor should be considered initially, whereas after treatment, rebound hyperplasia of the thymus may be the cause of enlargement.

Adolescent↗
PubMedDate not supplied

[Thin-needle aspiration biopsy in thoracic lesions. Analysis of 60 cases in a General Zone Hospital].

The intention of the study was to confirm the usefulness of the transthoracic fine needle biopsy aspiration (FNBA) procedure, in a second level hospital that did not have technologically advanced equipment to locate thoracic diseases, such as computerized tomography, fluoroscopy or ultrasonography. Employing a vertical and horizontal coordinate design and posteroanterior as well as lateral radiological studies, specimens were taken from 77 patients. Of this total only 60 (77.9%) were in proper conditions to be examined; in seven (11.6%) patients a second aspiration was required. Of the total suitable specimens, malignant neoplasms were found in 46 (76.7%), and inflammatory diseases were detected in 14 (23.3%). The most frequent diagnoses were squamous cell carcinoma in 20 (33.3%), undifferentiated carcinoma in seven (11.6%), and bronchoalveolar carcinoma in another seven (11.6%). In 12 patients, it was possible to obtain tissue samples and in two patients, autopsy was performed; in all of them, the FNBA diagnoses were confirmed. Four (6.6%) patients suffered complications like pneumothorax, three were cured spontaneously, and one was treated with tube drainage. FNBA demonstrated its usefulness in a hospital with limited technological resources; 77.9% of the patients were property diagnosed with reduced cost, minimal morbidity, and without mortality.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed2001

An atypical lymphoma of T-cell lineage in the thorax of an aged cow.

An aged beef cow was presented for signs of thoracic disease. A complete clinical and diagnostic workup suggested neoplasia. Postmortem examination revealed a lymphoma of T-cell lineage confined solely to the thoracic cavity, predominantly in lung tissue. The diagnosis was based on light and electron microscopy, immunohistochemistry, and negative bovine leukemia virus and bovine immunodeficiency virus results.

Animals↗
PubMedDate not supplied

Pancreatic involvement from heavily pretreated small cell lung cancer successfully treated with transcatheter intra-arterial chemotherapy: a case report with local and systemic disease control.

This is a case report on pancreatic metastases from small cell lung cancer successfully treated by transcatheter arterial infusion of chemotherapy. The patient showed partial regression of pancreatic and thoracic disease. To our knowledge this is the first reported case of small cell lung cancer with pancreatic involvement treated with the transcatheter arterial infusion procedure; it represents an example of integrated treatments that may be considered for patients with pancreatic involvement from small cell lung cancer even if heavily pretreated.

Aged↗
PubMed1968

Mobile chest radiography service for general practitioners.

In an eight-year period a mobile general practitioner chest x-ray referral service examined 100,000 patients referred by their family doctors. Of the patients examined, 8% were found to have previously undiagnosed significant thoracic disease. The incidence of pulmonary tuberculosis in need of treatment was 2.7 per thousand examinations (55% of them infectious). A total of 590 cases of primary cancer of lung were found. The incidence of this disease in men aged 45 and over was 19.4 per thousand examinations. A survey of general practitioners in the area concerned showed that they welcomed the service as a useful addition to their diagnostic facilities.

England↗
PubMed1984

The uses of diagnostic ultrasound in the thorax.

Modern real-time gray scale ultrasonography has contributed new diagnostic and therapeutic information in patients with diseases of the lungs and pleura. This article will discuss the ways in which ultrasound is most clinically useful in patients with thoracic disease.

Diaphragm↗
PubMedDate not supplied

[Pulmonary infection by Mycobacterium kansasii. Presentation of 27 cases (1988-1992)].

BACKGROUND: The aim of this study was to know the incidence of pulmonary disease by Mycobacterium kansasii in our medium in the general population with a description of the characteristics as well as the subjects which this disease affects. The incidence was related with the isolation of Mycobacterium tuberculosis on consideration of the hospital studied (practically a monography of thoracic diseases). METHODS: A retrospective review of the clinical histories of patients with positive cultures of Mycobacterium kansasii in respiratory samples was performed with the criteria of the pulmonary diseases attended in the authors center over the period from January 1988 to December 1992 being defined. A descriptive analysis of the clinical and radiographic variables, treatment and evolution was also carried out. RESULTS: Mycobacteria was isolated in 1,755 respiratory samples processed by the Laboratory of Microbiology with 95% corresponding to Mycobacterium tuberculosis and 4.5% to non tuberculin mycobacteria. Mycobacterium kansasii made up 83% of the latter (3.7% of global significant isolations). Pulmonary disease by Mycobacterium kansasii was diagnosed in 27 patients (26 males and 1 female) with a mean age of 48 years (range: 24-84 years). No disseminated forms of disease were observed in this series. The sputum demonstrated high diagnostic profitability (positive in 26/27). Clinical and radiological variables were unspecific (only 1 normal) with a high percentage of cavitation being observed (74%). Most were carriers of chronic and/or general pulmonary diseases. The evolution was favorable in 70.3% of the cases with 3 patients dying (11.1%), all with severe subjacent disease and one of a cause not related with the infection. Three recurrences were observed (11.1%) and 2 persistence of positive culture (7.4%). One of the strains was niacin positive (expectional feature). CONCLUSIONS: Mycobacterium kansasii is not a rare producer of disease in our medium in the general population being found in 3.7% of the total significant isolations of mycobacteria in respiratory samples in the authors center over the period from 1988 to 1992. It was found to be associated to pulmonary or general subjacent diseases preferable affecting middle-aged males. The clinical are radiological features were not specific with a high percentage of cavitation being observed. No disseminated disease was found. Conventional combined chemotherapy was effective with persistence and recurrence being seen in 11% and 7%, respectively. The prognosis of the disease was primarily determined by the basal situation of the host.

Adult↗